scholarly journals How Much do Needlestick Injuries Cost? A Systematic Review of the Economic Evaluations of Needlestick and Sharps Injuries Among Healthcare Personnel

2016 ◽  
Vol 37 (6) ◽  
pp. 635-646 ◽  
Author(s):  
Alice Mannocci ◽  
Gabriella De Carli ◽  
Virginia Di Bari ◽  
Rosella Saulle ◽  
Brigid Unim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Indirect Costs ◽  
Occupational Exposures ◽  
Direct Costs ◽  
Data Driven ◽  
Healthcare Personnel ◽  
Economic Evaluations ◽  
Modeling Studies ◽  
Intangible Costs ◽  
The Impact

OBJECTIVETo provide an overview of the economic aspects of needlestick and sharps injury (NSI) management among healthcare personnel (HCP) within a Health Technology Assessment project to evaluate the impact of safety-engineered devices on health careMETHODSA systematic review of economic analyses related to NSIs was performed in accordance with the PRISMA statement and by searching PubMed and Scopus databases (January 1997–February 2015). Mean costs were stratified by study approach (modeling or data driven) and type of cost (direct or indirect). Costs were evaluated using the CDC operative definition and converted to 2015 International US dollars (Int$).RESULTSA total of 14 studies were retrieved: 8 data-driven studies and 6 modeling studies. Among them, 11 studies provided direct and indirect costs and 3 studies provided only direct costs. The median of the means for aggregate (direct + indirect) costs was Int$747 (range, Int$199–Int$1,691). The medians of the means for disaggregated costs were Int$425 (range, Int$48–Int$1,516) for direct costs (9 studies) and Int$322 (range, Int$152–Int$413) for indirect costs (6 studies). When compared with data-driven studies, modeling studies had higher disaggregated and aggregated costs, but data-driven studies showed greater variability. Indirect costs were consistent between studies, mostly referring to lost productivity, while direct costs varied widely within and between studies according to source infectivity, HCP susceptibility, and post-exposure diagnostic and prophylactic protocols. Costs of treating infections were not included, and intangible costs could equal those associated with NSI medical evaluations.CONCLUSIONSNSIs generate significant direct, indirect, potential, and intangible costs, possibly increasing over time. Economic efforts directed at preventing occupational exposures and infections, including provision of safety-engineered devices, may be offset by the savings from a lower incidence of NSIs.Infect Control Hosp Epidemiol 2016;37:635–646

scholarly journals POS0530 HOW DOES MULTIMORBIDITY IMPACT ON THE DIRECT AND INDIRECT COSTS IN PATIENTS WITH RHEUMATOID ARTHRITIS?

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 498.3-499
Author(s):  
P. H. Hsieh ◽  
C. Geue ◽  
O. Wu ◽  
E. McIntosh
Keyword(s):  
Rheumatoid Arthritis ◽  
Early Rheumatoid Arthritis ◽  
Employment Status ◽  
Functional Disability ◽  
Hospital Admissions ◽  
Information Service ◽  
Indirect Costs ◽  
Direct Costs ◽  
Direct And Indirect Costs ◽  
The Impact

Background:Comorbidities are prevalent in patients with rheumatoid arthritis (RA) and associated with worse outcomes as well as higher economic burden. Little is known about the impact of multimorbidity on the direct and indirect costs of RA. Evidence of the incremental scale of these multimorbidity costs will usefully inform RA interventions and policies.Objectives:The aim of this study was to describe how multimorbidity impacts on the cost-of-illness, including direct and indirect costs, in patients with RA.Methods:The Scottish Early Rheumatoid Arthritis (SERA) is a registry of patients newly presenting with RA since 2011. It contains data on patient characteristics, clinical outcomes, health-related quality of life, and employment status data. These data were linked to routinely recorded hospital admissions and primary care prescribing data. Direct costs were estimated by applying relevant unit costs to healthcare resource use quantities. Indirect cost estimates were obtained from information on employment status and hospital admissions, valued by age and sex specific wages. Two-part models (probit followed by generalized linear model) were used to estimate direct and indirect costs, adjusting for age, gender, and functional disability. The Charlson Comorbidity Index (CCI) score was calculated using patient ICD-10 diagnoses from hospital records. The number of comorbidities was categorized into “RA alone”, “single comorbidity” and “multimorbidity (>1 comorbidity)”.Results:Data were available for 1,150 patients, 65.7% were female and a mean age of 57.5±14 years. The majority of patients only had RA (54.1%), followed by a single comorbidity (23.4%) and multimorbidity (22.5%). Annual total costs were significantly higher for patients with multimorbidity (£6,669 95% CI £4,871-£8,466; OR 11.3 95% CI 8.14-15.87) and for patients with a single comorbidity (£2,075 95% CI £1,559-£2,591; OR 3.52 95% CI 2.61-4.79), when compared with RA alone (£590). The excess costs were mainly driven by direct costs (£6,281 versus £1,875 versus £556). Although the difference in indirect costs between patients with multimorbidity and a single comorbidity were not statistically significant (£1,218 versus £914, p=0.11), patients with multimorbidity were associated with significantly higher costs than those with RA only (£594, p<0.01).Conclusion:The presence of comorbidity contributes significant excess to both direct and indirect costs among RA patients. In particular, patients with multimorbidity incurred substantially higher direct costs than those with a single comorbidity or RA only.Acknowledgements:The study analysed the data from the Scottish Early Rheumatoid Arthritis (SERA) study with a linkage to routinely recorded health data from Information Service Division, National Service Scotland. We would like to thank all the patients, clinical and nursing colleagues who have contributed their time and support to the study, the SERA steering committee for the approval, and Allen Tervit from the Robertson Centre for Biostatistics, University of Glasgow for the timely technical supports.Disclosure of Interests:Ping-Hsuan Hsieh: None declared, Claudia Geue: None declared, Olivia Wu Consultant of: OW has received consultancy fees from Bayer, Lupin and Takeda outside the submitted work., Emma McIntosh: None declared

scholarly journals Disease-Associated Costs in Children With Inflammatory Bowel Disease: A Systematic Review

2019 ◽  
Vol 26 (2) ◽  
pp. 206-215 ◽  
Author(s):  
Wael El-Matary ◽  
M Ellen Kuenzig ◽  
Harminder Singh ◽  
George Okoli ◽  
Mohammad Moghareh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Meta Analysis ◽  
Indirect Costs ◽  
Direct Costs ◽  
Variable Cost ◽  
Cost Estimates ◽  
Comorbidity Burden ◽  
Inflammatory Bowel

Abstract Background As a chronic noncurable disorder often diagnosed in childhood or adolescence, inflammatory bowel disease (IBD) confers a significant financial lifetime burden. The objective of this systematic review was to determine the disease-associated costs (both direct and indirect) associated with IBD in children and young adults. Methods We conducted a systematic review of the literature and included any study reporting direct health services–related costs or the indirect economic burden of IBD in persons aged ≤19 years (PROSPERO protocol number CRD2016036128). A technical panel of experts in pediatric gastroenterology and research methodology formulated the review questions, reviewed the search strategies and review methods, and provided input throughout the review process. Results Nine studies met criteria for inclusion, 6 of which examined direct costs, 1 of which examined both direct and indirect costs, 1 of which assessed indirect costs, and 1 of which assessed out-of-pocket (OOP) costs. Inflammatory bowel disease–associated costs were significantly higher compared with costs in non-IBD populations, with wide variations in cost estimates, which prevented us from conducting a meta-analysis. Costs in Crohn’s disease were higher than in ulcerative colitis. Overall, direct costs shifted from inpatient hospitalization as a major source of direct costs to medications, mainly driven by anti–tumor necrosis factor agents, as the leading cause of direct costs. Predictors of high costs included uncontrolled disease, corticosteroid treatment in the previous year, and comorbidity burden. Conclusions The pediatric literature examining IBD-attributable costs is limited, with widely variable cost estimates. There is a significant knowledge gap in the research surrounding indirect costs and OOP expenses.

scholarly journals O2C.6 The economic burden of occupational injuries and diseases in five european union countries

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A17.3-A18
Author(s):  
Emile Tompa ◽  
Amirabbas Mofidi ◽  
Young Jung ◽  
Thijmen van Bree ◽  
Swenneke van den Heuvel ◽  
...  
Keyword(s):  
European Union ◽  
The Netherlands ◽  
Economic Burden ◽  
Occupational Injuries ◽  
Indirect Costs ◽  
Monitoring And Evaluation ◽  
Economic Evaluations ◽  
European Union Countries ◽  
Cost Categories ◽  
The Impact

The objective of this study was to estimate the economic burden of occupational injuries and diseases in five European Union countries for the reference year 2015.We used a ‘bottom up’ approach to estimate the economic burden from a societal perspective for Finland, Germany, Italy, The Netherlands, and Poland. Three broad cost categories were considered—direct health care, indirect productivity, and intangible health-related quality of life costs. The methods started with data on newly diagnosed occupational injuries and diseases from calendar year 2015. We considered lifetime costs for cases across all cost categories. Sensitivity analysis was undertaken to assess the impact of key parameters.Indirect costs represent the largest proportion of total costs (with the exception is Poland), ranging from 66% for The Netherland to 43% for Poland. Intangible costs are the second highest, ranging from 49% for Poland to 21% for Finland and The Netherlands. Direct costs range from 16% for Finland to 8% for Poland.Average per case costing is highest for The Netherlands (€75,342), followed by Italy (€58,411), German (€44,919), Finland (€43,069) and lastly Poland (€38,918). Total costs as a percentage of GDP are highest for Poland (10.4%), followed by Italy (6.7%), The Netherlands (3.6%), Germany (3.3%) and lastly Finland (2.7%). In terms of costs per working population, the value is highest for Italy (€4,956), followed by The Netherland (€2,930), Poland (€2,793), Germany (€2,527) and lastly Finland (€2,331).The economic burden of occupational injuries and diseases in the countries considered are substantial, despite efforts to reduce adverse workplace exposures. Our case costs and total economic burden estimates provide a basis for undertaking economic evaluations of prevention efforts and can serve as a template for monitoring and evaluation at the country level. We advance the methods on several fronts.

scholarly journals Health Economic Studies of Colorectal Cancer and the Contribution of Administrative Data: a Systematic Review

2020 ◽  
Author(s):  
Elizabeth Lemmon ◽  
Catherine Hanna ◽  
Peter S Hall ◽  
Eva Morris
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Health Economic ◽  
Administrative Data ◽  
Indirect Costs ◽  
Economic Research ◽  
Future Research ◽  
Economic Evaluations ◽  
Potential Contribution ◽  
Health Economic Research

Introduction: Several forces are contributing to an increase in the number of people living with and surviving colorectal cancer (CRC). However, due to the lack of available data, little is known about those implications. In recent years, the use of administrative records to inform research has been increasing. The aim of this paper is to investigate the potential contribution that administrative data could have on the health economic research of CRC. Methods: To achieve this aim we conducted a systematic review of the health economic CRC literature published in the United Kingdom and Europe within the last decade (2009-2019). Results: Thirty-seven relevant studies were identified and divided into economic evaluations, cost of illness studies and cost consequence analyses. Conclusions: The use of administrative data, including cancer registry, screening and hospital records, within the health economic research of CRC is commonplace. However, we found that this data often comes from regional databases, which reduces the generalisability of results. Further, administrative data appear less able to contribute towards understanding the wider and indirect costs associated with the disease. We have identified several ways in which various sources of administrative data could enhance future research in this area.

scholarly journals The Impact of Enhanced Recovery After Surgery on Total Joint Arthroplasty: Protocol for a Systematic Review and Meta-analysis

10.2196/25581 ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. e25581
Author(s):  
Siddharth Rele ◽  
Cade Shadbolt ◽  
Chris Schilling ◽  
Nicholas F Taylor ◽  
Michelle M Dowsey ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Service ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Recovery Of Function ◽  
Meta Analysis ◽  
Current Evidence ◽  
Cochrane Library ◽  
Economic Evaluations ◽  
The Impact

Background The number of total joint arthroplasties (TJAs) being performed is increasing worldwide. To match this increasing demand, there has been focus on hastening patients’ recovery of function. This effort has culminated in the formulation of enhanced recovery after surgery (ERAS) strategies. However, with evolving ERAS programs and new recommendations, a review of current evidence is required to provide clinicians with up-to-date information about its effect on outcomes for TJA. Objective The objective of this study is to assess the utility of ERAS programs on patient, health service, and economic outcomes for primary, elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods A systematic search will be conducted in Medline (Ovid), EMCARE (Ovid), EMBASE (Ovid), Web of Science, CINAHL, National Health Service Economic Evaluations Database, and the Cochrane Library. Analytical, observational, and experimental designs will be included in this systematic review. Only studies including patients undergoing primary TKA and THA comparing ERAS programs with conventional surgery and postoperative care will be included. Data related to patient outcomes, health service outcomes, safety, and economic evaluation will be extracted. Results The search terms and primary database searches have been finalized. Findings will be reported in narrative and tabular form. Where appropriate, random effects meta-analyses will be conducted for each outcome, and heterogeneity quantified with Cochran Q test and I2 statistic. Measures of effect or mean differences will be reported with 95% confidence intervals. The results of this systematic review will be disseminated in a peer-reviewed journal. Conclusions This protocol will guide a systematic review assessing outcomes associated with ERAS surgery in primary THA and TKA. Trial Registration Open Science Framework osf.io/y4bhs; https://osf.io/y4bhs International Registered Report Identifier (IRRID) PRR1-10.2196/25581

scholarly journals Economic burden of schizophrenia in Italy: a probabilistic cost of illness analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018359 ◽  
Author(s):  
Andrea Marcellusi ◽  
Gianluca Fabiano ◽  
Raffaella Viti ◽  
Pier Cesare Francesa Morel ◽  
Giuseppe Nicolò ◽  
...  
Keyword(s):  
Cost Of Illness ◽  
Economic Burden ◽  
Indirect Costs ◽  
Direct Costs ◽  
Psychiatric Disease ◽  
Resource Utilisation ◽  
Treatment Pathways ◽  
Specialist Services ◽  
Illness Model ◽  
The Impact

ObjectivesSchizophrenia is a chronic, debilitating psychiatric disease with highly variable treatment pathways and consequent economic impacts on resource utilisation. The aim of the study was to estimate the economic burden of schizophrenia in Italy for both the societal and Italian National Healthcare perspective.MethodsA probabilistic cost of illness model was applied. A systematic literature review was carried out to identify epidemiological and economic data. Direct costs were calculated in terms of drugs, hospitalisations, specialist services, residential and semiresidential facilities. Indirect costs were calculated on the basis of patients’ and caregivers’ loss of productivity. In addition, the impact of disability compensation was taken into account using a database from the Italian National Social Security Institute —Italy (INPS).ResultsOverall, 303 913 prevalent patients with schizophrenia were estimated. Of these, 212 739 (70%) were diagnosed and 175 382 (82%) were treated with antipsychotics. The total economic burden was estimated at €2.7 billion (95% CI €1771.93 to €3988.65), 50.5% due to indirect costs and 49.5% to direct costs. Drugs corresponded to 10% of direct costs and hospitalisations (including residential and semiresidential facilities) accounted for 81%.ConclusionsThis study highlighted that indirect costs and hospitalisations (including residential and semiresidential facilities) play a major role within the expenses associated with schizophrenia in Italy, and this may be considered as a tool for public decision-makers.

scholarly journals Towards Financial Valuation in Data-Driven Companies

2016 ◽  
Vol 12 (2) ◽  
pp. 28-33
Author(s):  
M. Eugenia Pérez-Pons ◽  
Alfonso González-Briones ◽  
Juan M. Corchado
Keyword(s):  
Economic Value ◽  
Indirect Costs ◽  
Added Value ◽  
Data Driven ◽  
Financial Valuation ◽  
External Data ◽  
Time Period ◽  
The Impact ◽  
A Company

The following work presents a methodology of determining the economic value of the data owned by a company in a given time period. The ability to determine the value of data at any point of its lifecycle, would make it possible to study the added value that data gives to a company in the long term. Not only external data should be considered but also the impact that the internal data can have on company revenues. The project focuses on data-driven companies, which are different to the data-oriented ones, as explained below. Since some studies affirm that data-driven companies are more profitable, the indirect costs of using those data must be allocated somewhere to understand their financial value14 and to present a possible alternative for measuring the financial impact of data on the revenue of companies.

scholarly journals Which interactions matter in economic evaluations? A systematic review and simulation study

2020 ◽  
Author(s):  
Helen A Dakin ◽  
Alastair Gray
Keyword(s):  
Systematic Review ◽  
Statistical Significance ◽  
Simulated Data ◽  
Economic Evaluations ◽  
Net Benefit ◽  
Life Years ◽  
Randomised Controlled ◽  
Main Effects ◽  
Effect Ratio ◽  
The Impact

Abstract Background: We aimed to assess the magnitude of interactions in costs, quality-adjusted life-years (QALYs) and net benefits within a sample of published economic evaluations of factorial randomised controlled trials (RCTs), evaluate the impact that different analytical methods would have had on the results and compare the performance of different criteria for identifying which interactions should be taken into account.Methods: We conducted a systematic review of full economic evaluations conducted alongside factorial RCTs and reviewed the methods used in different studies, as well as the incidence, magnitude, statistical significance, and type of interactions observed within the trials. We developed the interaction-effect ratio as a measure of the magnitude of interactions relative to main effects. For those studies reporting sufficient data, we assessed whether changing the form of analysis to ignore or include interactions would have changed the conclusions. We evaluated how well different criteria for identifying which interactions should be taken into account in the analysis would perform in practice, using simulated data generated to match the summary statistics of the studies identified in the review.Results: Large interactions for economic endpoints occurred frequently within the 40 studies identified in the review, although interactions rarely changed the conclusions. Conclusions: Simulation work demonstrated that in analyses of factorial RCTs, taking account of all interactions or including interactions above a certain size (regardless of statistical significance) minimised the opportunity cost from adopting treatments that do not in fact have the highest true net benefit.

scholarly journals Economic burden of rheumatoid arthritis: a systematic review of literature in biologic era

2020 ◽  
pp. annrheumdis-2019-216243 ◽  
Author(s):  
Ping-Hsuan Hsieh ◽  
Olivia Wu ◽  
Claudia Geue ◽  
Emma McIntosh ◽  
Iain B McInnes ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Work Disability ◽  
Indirect Costs ◽  
Direct Costs ◽  
Population Characteristics ◽  
Considerable Proportion ◽  
Cost Component ◽  
Main Component ◽  
Over Time

BackgroundThe past decades have seen rapid advances in the treatment of rheumatoid arthritis (RA). In particular, the introduction of biologic and targeted synthetic disease-modifying antirheumatic drugs have improved clinical outcomes and reconfigured traditional RA cost compositions.ObjectivesTo map the existing evidence concerning cost of illness of RA, as the treatment pathway evolves in the biologic era, and examine how costs have been measured and estimated, in order to assemble and appropriately interpret available data.MethodsSystematic review of studies that estimated the costs of patients with RA. Multiple electronic databases were searched to identify studies published between 2000 and 2019. The reported total costs and cost components were evaluated according to the study and population characteristics. The Cochran-Armitage test was used to determine statistically significant trends in increasing or decreasing proportions over time.ResultsOverall, 72 studies were included. Drug costs compromised the main component (up to 87%) of direct costs with an increasing trajectory over time, although not statistically significant. The proportion of costs for hospitalisation showed a statistically significant decrease chronologically (p=0.044). Indirect costs, primarily associated with absenteeism and work disability accounted for 39% to 86% of total costs. The reported indirect costs are highly sensitive to the approach to estimation.ConclusionsA decreasing trend in inpatient costs chronologically suggested a cost shift in other components of direct costs. Indirect costs still contributed a considerable proportion of total costs, with work disability being the main cost component. Economic analyses that do not incorporate or appropriately measure indirect costs will underestimate the full economic impact of RA.

scholarly journals Inclusion of Safety-Related Issues in Economic Evaluations for Seasonal Influenza Vaccines: A Systematic Review

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 111
Author(s):  
Tanja Fens ◽  
Pieter T. de Boer ◽  
Eugène P. van Puijenbroek ◽  
Maarten J. Postma
Keyword(s):  
Cost Effectiveness ◽  
Seasonal Influenza ◽  
Indirect Costs ◽  
Cost Effective ◽  
Initial Study ◽  
Influenza Vaccines ◽  
Economic Evaluations ◽  
Cost Share ◽  
Life Years ◽  
The Impact

(1) Background: Vaccines for seasonal influenza are a good preventive and cost-effective strategy. However, it is unknown if and how these economic evaluations include the adverse events following immunization (AEFI), and what the impact of such inclusion is on the health economic outcomes. (2) Methods: We searched the literature, up to January 2020, to identify economic evaluations of seasonal influenza vaccines that considered AEFIs. The review protocol was published in PROSPERO (CDR42017058523). (3) Results: A total of 52 economic evaluations considered AEFI-related parameters in their analyses, reflecting 16% of the economic evaluations on seasonal influenza vaccines in the initial study selection. Most studies used the societal perspective (64%) and evaluated vaccination of children (37%). Where considered, studies included direct medical costs of AEFIs (90%), indirect costs (27%), and disutilities/quality-adjusted life years loss due to AEFIs (37%). The majority of these studies accounted for the effects of the costs of AEFI on cost-effectiveness for Guillain–Barré syndrome. In those papers allowing cost share estimation, direct medical cost of AFEIs was less than 2% of total direct costs. (4) Conclusions: Although the overall impact of AEFIs on the cost-effectiveness outcomes was found to be low, we urge their inclusion in economic evaluations of seasonal influenza vaccines to reflect comprehensive reports for the decision makers and end-users of the vaccination strategies.

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